Program helps bridge the gap in cancer care

David Zappa, 34, sits near his free weight sets that have gone unused since his treatment for colon cancer last year. He is undergoing physical therapy for the lingering effects of his chemotherapy treatment, but hopes to be able to work out again soon.EUGENE GARCIA, THE ORANGE COUNTY REGISTER

David Zappa, 34, finished treatment for colon cancer last year with a sense of relief, but also with fatigue, pain and uncertainty.

"As soon as I was done with chemo, I had no direction," Zappa said. "Now you're on your own. I'm faced with all these symptoms and all these things I don't know what to do with."

Months later, his oncologist referred him to a new St. Jude Medical Center program that offers rehabilitation to help cancer patients rebuild their bodies and lives. Services include physical, occupational and speech therapy as well as gym-style exercise classes. The specially trained team includes social workers, psychologists and nutritionists.

The six-week program is covered by Medicare and private insurance companies.

"They wanted to know what my goals were and the specifics of my problems," Zappa said. "I mentioned back pain, fatigue, energy and strength. All those were addressed, and body mechanics. I had so much improvement."

The program, called Survivorship Training and Rehabilitation, or STAR, was developed by a Harvard Medical School professor after her diagnosis of breast cancer while in her 30s.

"I realized there was a big gap in care," said founder Dr. Julie Silver, whose specialty is rehabilitation medicine. "If you've been in a serious car accident or had a stroke or a hip replacement, you go through rehabilitation. In oncology, many patients are sent home and told to accept a new normal."

Silver said research shows the top cause of distress among cancer survivors stems from the disability they experience from radiation or chemo, such as trouble swallowing, incontinence or nerve damage.

"There's a very strong psychological fallout from those problems," Silver said. "When you offer rehab, you're supporting survivors both physically and emotionally."

An estimated 13.7 million cancer survivors live in the U.S., and the figure is forecast to reach nearly 18 million in 10 years, according to a recent report by the American Cancer Society. According to the Centers for Disease Control and Prevention, survivors may face physical, emotional, social, spiritual and financial challenges after their diagnosis and treatment. Experts say addressing the varied needs of survivorship – not just monitoring for recurrence – is essential.

"People now live six times longer after their cancer diagnosis than they did 40 years ago," said Sue Potts, a physical therapist and manager of St. Jude's outpatient rehab. "The treatments have definitely become better, but they're still toxic to the body. Cancer treatment is about surviving. Rehab is about regaining your life."

Potts said nearly 40 patients have completed the program since May, with the ideal time for rehab taking place three to six months after the end of treatment.

"We may not get you to your previous level of function, but we can get you to a higher level than you would have achieved on your own," she said.

Ana de Perez, 43, had breast cancer a decade ago and was diagnosed again last year. She underwent a hysterectomy, a bilateral mastectomy, chemo and reconstructive surgery.

"After that, I felt like my body had been run over by a freight train," said de Perez, who lives in Chino.

David Zappa, 34, sits near his free weight sets that have gone unused since his treatment for colon cancer last year. He is undergoing physical therapy for the lingering effects of his chemotherapy treatment, but hopes to be able to work out again soon. EUGENE GARCIA, THE ORANGE COUNTY REGISTER
David Zappa, 34, holds a candle that signifies his completion of treatments for colon cancer last year. Zappa has been undergoing physical therapy to help him deal with the chemotherapy's lingering side effects. EUGENE GARCIA, THE ORANGE COUNTY REGISTER
David Zappa plays the guitar that helped him deal with his chemotherapy treatments for colon cancer last year. Zappa's great uncle was the legendary rock musician Frank Zappa. EUGENE GARCIA, THE ORANGE COUNTY REGISTER
David Zappa, 34, describes the lingering effects from his treatment for colon cancer last year. He still feels headaches and has a low tolerance for heat. EUGENE GARCIA, THE ORANGE COUNTY REGISTER
David Zappa shows his sense of humor during chemotherapy treatments last year as he flashes a thumbs-up sign. Zappa credits laughter during his treatments as a way that he dealt with the difficult situation. COURTESY OF DAVID ZAPPA
Ana de Perez watches as physical therapist Ami Patel, right, shows her how to do an exercise during a session in the St. Jude Cancer and Rehabilitation and Wellness Program. Perez is undergoing therapy to help her cope with the after effects of her breast cancer treatment. PAUL RODRIGUEZ, THE ORANGE COUNTY REGISTER
Under the watchful eye of physical therapist Ani Patel of the St. Jude Cancer Rehabilitation and Wellness Program, breast cancer survivor Ana de Perez does an exercise to help her relieve pain related to her cancer treatment. PAUL RODRIGUEZ, THE ORANGE COUNTY REGISTER
Physical therapist Ami Patel of the St. Jude Cancer Rehabilitation and Wellness Program helps Ana de Perez loosen her neck and shoulder muscles during a physical therapy session. De Perez is a breast cancer survivor dealing with the after effects of her cancer treatment. PAUL RODRIGUEZ, THE ORANGE COUNTY REGISTER
Breast cancer survivor Ana de Perez, left, walks through a balance exercise with the help of Ami Patel of the St. Jude Cancer Rehabilitation and Wellness Program. PAUL RODRIGUEZ, THE ORANGE COUNTY REGISTER
Breast cancer survivor Ana de Perez does an exercise to help stretch her neck and shoulder muscles during a physical therapy session of the St. Jude Cancer Rehabilition and Wellness Program. PAUL RODRIGUEZ, THE ORANGE COUNTY REGISTER

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